Molar Incisor Hypomineralization Research Articles

Investigation on the effects of long-term antibiotic therapy in sickle cell disease associated with molar-incisor hypomineralisation-a pilot study.

The term Molar-Incisor Hypomineralisation (MIH) is used to describe hypomineralised defects of systemic origin that affect at least one of the first permanent molars and often involves the permanent incisors. Antibiotic therapy during amelogenesis may be associated with enamel hypomineralisation. By examining children with Sickle Cell Disease (SCD), who take prophylactic antibiotics daily from birth until age five, it may be possible to determine if there is an increased prevalence of MIH in this population. The aim of this study was to determine the effect of long-term antibiotic use on the prevalence and severity of MIH in children with SCD. In a prospective cohort pilot study over a period of seven months, children aged 7-17 years, with SCD at Boston Children's Hospital (n = 18) were examined for MIH. Information regarding peri-natal concerns, incidence of illness and antibiotic use were also collected. The results were compared to a group of control patients (n = 63) for prevalence and severity of MIH using Fisher's exact test. The patients with SCD, 4/18 (22%) taking daily antibiotics did not show a statistically significant greater prevalence of MIH compared to the control group, 24/63 (38%). There was no correlation between MIH and pneumonia, asthma, fever, flu, otitis media, breastfeeding, gender and birth weight. However, an association was noted between premature birth and MIH (p ≤ 0.05). No correlation was found between long-term antibiotic use and higher prevalence of MIH in the SCD group compared to the control group. However, MIH may be more severe in those with a history of long-term antibiotics.

MIH and compromised permanent first molars. When and which teeth to extract: guidelines

The prevalence of molar incisor hypomineralisation (MIH), the degree of severity of experienced molars, their medium-term survival rate are factors that have reintroduced the decision to extract first permanent molars, forced extractions or chosen therapeutic option. The author summarizes pedodontic and orthodontic clinical studies in the management of patients with compromised first permanent molars in order to analyze the consequences of single or multiple extractions of these teeth. Firstly, the consequences of extractions of the first permanent molars in the absence of malocclusion are studied. The goal is the establishment of all the teeth without orthodontic treatment. The impact of the age at which the extraction is practiced is a key factor. In a second step, extractions of first permanent molars in the presence of orthodontic anomalies are analyzed to define the optimal therapeutic strategies, the precautions during these treatments, the contraindications. Consultation and good coordination between the generalist dentist / pediatric dentist and orthodontist are the key factors for stable and functional end-of-treatment results and optimized treatment duration. Clinical experience and knowledge make it possible to properly select patients qualified for these therapies who obtain multidisciplinary planning and good biomechanical control. By bringing together optimal decision-making conditions, extraction is a therapeutic option that often proves to be superior to a restorative option in providing our patients with the greatest long-term service.

A comparison of two different management techniques for extensive molar defects in patients suffering from Molar Incisor Hypomineralization (MIH) (A Randomized Clinical Trial)

A comparison of two different management techniques for extensive molar defects in patients suffering from Molar Incisor Hypomineralization (MIH) (A Randomized Clinical Trial)

Preventive efficacy of silver diamine fluoride and MI Varnish on molars affected by molar incisor hypomineralization in children: A randomized controlled trial

Background: This randomized controlled trial aimed to compare the efficacy of silver diamine fluoride (SDF) and MI Varnish in preventing caries development, enamel breakdown, and sensitivity on molars affected by molar incisor hypomineralization (MIH) in children. Methods: A total of 100 children aged 6 to 9 years were enrolled in the study with two contralateral permanent molars mildly affected by MIH. Affected molars were randomly and equally assigned to receive either SDF or MI Varnish treatment. The interventions were applied at four different time points (baseline, 3, 6, 9 months), and the incidence of caries, caries progression, enamel breakdown, and sensitivity were assessed. Results: The findings of this study revealed significant differences in the incidence of caries between the groups treated with SDF and MI Varnish (P-value < 0.05). Similarly, there was a significant difference in caries progression between the two groups (P-value < 0.05). However, no significant differences were observed in enamel breakdown scores between the treatment groups, as the majority of teeth in both groups exhibited a score of 0. Furthermore, there were no significant differences in sensitivity between the treatment groups throughout the study period. Conclusions: In conclusion, the results of this study provide evidence that molars treated with SDF demonstrated a lower incidence of caries and a higher rate of caries arrest compared to those treated with MI Varnish. Both interventions showed promise in preventing enamel breakdown and improving sensitivity. These findings highlight the potential of SDF and MI Varnish as effective treatments for caries prevention and management, emphasizing the importance of early intervention and appropriate dental care strategies in maintaining oral health. Trial registration: ISRCTN54243749 (13/01/2022).

Molar-incisor hypomineralization in a cohort of individuals born with cleft lip and palate.

This study aimed to investigate the frequency of molar-incisor hypomineralization (MIH) in individuals born with cleft lip and or cleft palate. Three hundred eighty-six individuals born with cleft lip and/or palate before orthodontic treatment. All the individuals were submitted to a clinical examination and intraoral standardized photos. The registration of MIH was taken by two orthodontists and analysed in association with the cleft type and laterality. The Kruskal-Wallis test and the regression test were used to compare the frequency of molars and incisors affected according to cleft type and laterality, sex and age. We found a frequency of 67.87% of MIH in the studied sample. The frequency varied from 25% (in individuals born with cleft palate) to 77% in individuals born with bilateral cleft lip and palate). The number of affected molars was statistically different depending on cleft type and laterality (P < .001- Kruskal-Wallis test). Differences were found between individuals born with unilateral cleft lip and palate and unilateral cleft lip and alveolus (P = .03), and with isolated cleft palate (P = .03), and between individuals born with bilateral cleft lip and palate and born with unilateral cleft lip and alveolus (P = .01), and cleft palate (P = .01). Sex (P = .21) and age (P = .36) had no influence on the frequency of MIH. A positive correlation was found between the number of molars affected and incisors affected (P < .001). Individuals born with cleft lip and palate have a higher frequency of MIH, and the complexity of cleft type was associated with the number of affected molars.

Predictive Value of Hypomineralization of Second Primary Molars for Molar Incisor Hypomineralization and Other Relationships between Both Developmental Defects of Dental Enamel.

Molar incisor hypomineralization (MIH) and hypomineralized second primary molars (HSPM) are dental enamel developmental defects with significant prevalence and psychophysical impact, posing a public health concern. We examined the relationship between HSPM and MIH in 426 children aged 7 to 10 years (213 with MIH, 213 without MIH). The frequency of HSPM was higher in children with MIH (37.1% vs. 11.3%, p < 0.001). However, there was no correlation between MIH severity and presence of HSPM (p = 0.296). In patients with both defects (n = 79), 90% of severe MIH cases were associated with severe HSPM, while 87.8% of mild MIH cases were associated with mild HSPM (p < 0.001). The involvement of permanent incisors by MIH was not influenced by the presence of HSPM or HSPM severity. HSPM exhibited a positive predictive value of 76.7, negative predictive value of 58.8, sensitivity of 37.1% (95% CI = 30.6-43.6%), and specificity of 88.7% (95% CI = 84.5-93%). The odds ratio for MIH based on HSPM was 4.64 (95% CI). HSPM may serve as a predictor of MIH, but its absence does not rule out the occurrence of MIH. The results highlight the need for surveillance programs in children presenting with HSPM to facilitate early diagnosis and preventive measures for MIH-related complications.

Minimally Invasive Therapy for Treating White Spot Lesions on Anterior Teeth in Molar Incisor Hypo Mineralization

Molar Incisor Hypomineralization (MIH) is a systemic hypomineralization that can induce stained enamel opacities of anterior teeth. Due to high prevalence of these cases

Knowledge, experience and perception regarding Molar Incisor Hypomineralisation (MIH) among pediatric dentists in Manaus, Amazonas

To assess the knowledge and perceptions about MIH among pediatric dentists, a cross-sectional study was carried out by the application of online questionnaires to 50 pediatric dentists registered at Amazonas Council of Dentistry which were divided, according to the place of work, into two groups: Group I-Private offices, university and public service of Primary Health Care and Group II -Dentistry Specialized Centers -CEOs. Most participants were female (94.0%), with a mean age of 42.3 years (±8.3) and professional experience ≥15 years. Although almost all respondents knew MIH (98%) and performed treatment in affected patients (96%), 95.9% said they were not prepared to complete the differential diagnosis, and only 4.1% were confident in defining the treatment. The most clinical challenges faced in treating a patient with MIH were the longevity of restorations (73.5%) and tooth sensitivity (63.3%). The total mean score of the professionals' knowledge was 25.9. There was no difference between the two groups' knowledge of MIH. The perception of MIH of pediatric dentists in Manaus was good. Still, there is an urgent need to clinically train dentists about MIH to ensure confidence in diagnosing this enamel defect early.

Direct or indirect composite for restoring permanent first molars affected by Molar Incisor Hypomineralisation (MIH): a randomized clinical controlled trial

AimThis study was undertaken to compare direct composite resin restorations (DCRR) and indirect composite resin restorations (ICRR) for treating permanent first molars affected by MIH in terms of clinical performance.Materials and methodsThis was a controlled, randomized, clinical split-mouth study. The studied sample consisted of 40 asymptomatic first permanent hypomineralised mandibular molars in 20 children aged between 7–11 years, these cases were divided randomly into two groups: Group 1 (experimental): 20 first permanent mandibular molars were restored with ICRR, and Group 2 (control): 20 first permanent mandibular molars that were restored with DCRR. The cavity was prepared using a diamond bur on a high-speed handpiece, and the prepared cavity was wiped with cotton moistened with sodium hypochlorite. The composite was applied directly with a total-etch bonding system. In the ICRR group, an impression for the prepared cavity was taken using a silicon-based material, and the restoration was adhesive with self-adhesive resin cement. The child’s satisfaction with each of the two application techniques was assessed through the scale FACES. Restorations were evaluated during follow-up periods (3, 6, and 12 months) according to Modified USHPH criteria.ResultsThe clinical success rate was 90% in the ICRR group versus 85% in the DCRR group after 12 months of follow-up without statistically significant differences (P = 0.218). Children were significantly more satisfied (P = 0.0351) with ICRR than DCRR.ConclusionsBoth DCRR and ICRR can be considered effective restorations with acceptable clinical performance in the restoration of hypomineralised first permanent molars with an advantage of ICRR in terms of child acceptance of the restoration application technique.

A clinical and statistical study on enamel hypomineralization of the first permanent molar in the period of mixed dentition.

The first permanent molar (FPM) is the first tooth in the permanent dentition that emerges in the oral cavity, at around the age of six and behind the deciduous teeth, thus converting the primary dentition into a mixed dentition. Its early formation represents a risk factor for the onset of hard dental tissues disorders, the most common being the molar incisor hypomineralization (MIH). The aim of the study was to assess the hypomineralization type of developmental defects of enamel at FPM level during the mixed dentition stage, in a group of Romanian children. The research was conducted on 87 patients, 44 females and 43 males, divided into the following age groups: 5-6 years, 6-7 years, 7-8 years, 8-9 years, 9-10 years, 10-11 years, 11-12 years and older than 12 years. All children were examined in the dental office by a pediatric dentist. Of the subjects, 40.2% presented hypomineralization lesions on the FPM. Among the affected children, 62.9% were girls and 37.1% were boys. Mild forms were the most prevalent, being found in 71.4% of the affected subjects. Moderate forms were present in 22.9% and severe forms in 5.7% of the affected children. MIH prevalence significantly decreased with increasing age. Only two children belonging to the group 8-9 years and 10-11 years, respectively, showed severe MIH lesions. Statistically significant differences were determined in what regards the distribution of MIH children according to the severity of the lesions in relation to age (p=0.007). Children 6- to 7-year-old have been the most affected by FPM hypomineralization, which indicates the need for early management of the disease, through a thorough diagnosis, and preventive and interceptive therapeutic approaches.

Prevalence and severity of molar-incisor hypomineralization, is there an association with socioeconomic status? A cross-sectional study in Chilean schoolchildren.

Data about molar-incisor hypomineralization (MIH) prevalence and its severity remains limited for some Latin American countries. Furthermore, its association with socioeconomic status (SES) is still unclear. Thus, this study aims to determine the prevalence and severity of MIH in Santiago, Chile and explore its association with SES. A cross-sectional study with schoolchildren between 6 and 12 years was conducted. Children were evaluated using the European Academy of Paediatric Dentistry to diagnose MIH, and the Mathu-Muju and Wright criteria to determine its severity. A total of 1,270 children were included. The MIH prevalence was 12.8% without association with gender (p = 0.609). Prevalence was higher among schoolchildren ages 8 and 9 (p = 0.002), and in lower SES (p = 0.007). MIH mild cases were the most prevalent (63%), and severity was not related to gender (p = 0.656), age (p = 0.060), or SES (p = 0.174). The prevalence of MIH in the province of Santiago, Chile is 12.8% and was found to have a higher incidence in 8-9-year-old students and among those categorized by low SES. Furthermore, MIH prevalence was associated with low SES. Public health policies to address MIH in Chile should start with schoolchildren aged 8 to 9,and with low SES.

Penyakit pada anak sebagai salah satu faktor etiologi molar incisor hypomineralization : scoping review

Background: Molar incisor hypomineralization is one of the major developmental defects of enamel affecting one or more first permanent molars and is often associated with incisor involvement. MIH is thought to be idiopathic, but the etiology is not yet known. Objective: The aim of this study was to determine the relationship between postnatal factors, namely the disease suffered by children aged 0-3 years and MIH in the group of children aged 6-15 years. Methods: The study was conducted using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagram through databases such as Google Scholar, PubMed, Wiley, and Science Direct using keywords of ((molar incisor hypomineralization) AND (permanent molar)) AND (etiology). Results: 32 articles that fits the criteria were found and were divided into 2 categories, namely: disease in children as a factor for MIH and disease in children associated with MIH. Conclusion: Based on the results of the study, it can be concluded that there is a relationship between disease in children aged 0-3 years and the occurrence of MIH in children aged 6-15 years. Respiratory disease at an early age was associated with the occurrence of MIH most frequently.

Clinical evaluation of resin infiltration treatment masking effect on hypomineralised enamel surfaces

BackgroundResin infiltration is a micro-invasive treatment for molar incisor hypomineralisation (MIH). In this study it was aimed to evaluate the masking effect of resin infiltration treatment (ICON) on hypomineralised enamel surface of permanent anterior teeth by using laser fluorescence, spectrophotometer, and cross-polarisation photography.MethodsA total of 116 permanent central incisors in 37 patients were included in the study. The resin infiltration treatment (Icon®) was applied to the teeth with MIH; the healthy teeth received no treatment (control). Hypomineralised enamel lesions were evaluated by ICDAS II criteria. DIAGNOdent Pen was used to assess the lesions and healthy enamel surface quantitatively. Colour changes in enamel lesions were evaluated by using a spectrophotometer (VITA EasyShare). Each enamel lesion was imaged using a cross-polarization technique before and after treatment. All photos were assessed using Image J to evaluate the changes in lesion size. Enamel lesions were evaluated before; immediately after; 1; 3; and 6 months after treatment. Statistical significance was set as p < 0.05.ResultsAfter the resin infiltration, significant decreases were found in the mean DIAGNOdent values for the treatment group (p < 0.05). The colour differences before and after treatment significantly differed in all follow-ups (p < 0.05). In the treatment group, lesion areas decreased significantly after treatment (p < 0.05).ConclusionsThe resin infiltration treatment has a masking effect on MIH lesions without cavities, with stable outcomes after six months. The cross-polarization photography technique may be use to evaluate the lesion size instead of photography with flash.Trial registration.NCT04685889 (registered 28 December 2020).

Prevalence and risk factors of molar incisor hypomineralization in school children: A cross-sectional study in North Kerala, India

Introduction: Molar incisor hypomineralization (MIH) is a developmental enamel defect affecting permanent molars and incisors, leading to dental challenges. The prevalence and associated risk factors of MIH vary globally, highlighting the need for region-specific studies. The primary objectives of this cross-sectional study were to determine the prevalence of MIH in 7- to 11-year-old school children, investigate associated risk factors, and analyze the clinical manifestations. Materials and methods: A random sample of 10,000 children aged 7 to 11 years from 10 primary schools in North Kerala underwent oral examinations. The study utilized a two-part proforma, including demographic details, parental interviews, and clinical assessments using a modified developmental defect of enamel index. The data were analyzed using the chi-square test and SPSS software. Ethical approval and parental consent were obtained. Results: Out of 2170 children examined, the prevalence of MIH was 8.2%. Males showed a higher prevalence (62.92%), with maxillary molars being predominantly affected. The study revealed significant associations between MIH and antenatal factors, antibiotic usage, and maternal illnesses. Maxillary molars were more frequently affected than mandibular molars, with specific teeth showing varying degrees of susceptibility. Conclusion: As children’s age increased, the severity of MIH defects in the first permanent molars escalated, indicating progressive enamel defects. The prevalence of MIH was more pronounced in the upper arch, with both maxillary and mandibular first permanent molars being equally affected. The study identified factors such as polychlorinated biphenyls (PCBs)/dioxins, medical illness problems, malnutrition, fluoride exposure, common medical diseases, and genetic disorders as potential contributors to MIH defects. Early diagnosis and intervention are crucial for managing the challenges posed by MIH-affected teeth.

Prevalence of Molar Incisor Hypomineralization Among a Group of Egyptian Children in Fayoum governorate Schools: A Cross Sectional study

Prevalence of Molar Incisor Hypomineralization Among a Group of Egyptian Children in Fayoum governorate Schools: A Cross Sectional study

Development of undergraduate students' diagnostic accuracy for the classification of molar incisor hypomineralization.

One of the major difficulties with respect to molar incisor hypomineralization (MIH) is its classification and differentiation from other enamel development defects (EDDs). The aim of this study was to evaluate diagnostic accuracy in dental students to classify MIH as well as its differentiation from other EDDs by combining conventional theoretical classes and e-learning-assisted pre-clinical practices. In this one-group pre-test and post-test study, 59 second-year students assessed 115 validated photographs using the MIH Index on the Moodle learning platform. This index assesses the clinical features and extent of MIH, differentiating it from other EDDs. Students received automatic feedback after the pre-test. Two weeks later, students re-evaluated the same photographs. Both pairwise accuracy and overall diagnostic accuracy were estimated and compared for pre- and post-testing, with the area under the curve AUC, along with 95% confidence intervals (95% CI). The lowest diagnostic accuracy was for the ability to discriminate between white or cream-coloured demarcated opacities and hypomineralization-type defect that is not MIH. The overall pre-test accuracy was AUC = 0.83 and increased significantly post-test to AUC = 0.99 (p < .001). The overall accuracy to discriminate the extent of the lesion also increased significantly post-test (p < .001). Diagnostic skills to classify MIH can be developed by combining conventional theoretical classes and e-learning-assisted pre-clinical practices.

Contemporary Understanding of the Etiology and Management of Molar Incisor Hypomineralization: A Literature Review.

Molar incisor hypomineralization (MIH) is a significant health problem that can affect the child's quality of life by negatively affecting their esthetics and function. This review aimed to summarize the etiology and pathogenesis of MIH. It also aimed to summarize the recent studies on MIH in children and adolescents, focusing on diagnosis, prevention, and clinical management. An electronic search on the PubMed, Cochrane Database of Systematic Reviews, MEDLINE, MedlinePlus, WHO reports, and Google Scholar databases was performed. The volume of research on the etiology, presentation, and clinical management of MIH is still expanding. The creation and validation of indices for the diagnosis and management of MIH, as well as any potential genetic aspects appear to be the main areas of current research. Notably, MIH was linked to childhood illnesses, the use of antibiotics, and early childhood fever. Although many studies discuss the different options for managing MIH lesions, evidence-based studies that address the long-term outcomes of MIH are still lacking. Indeed, future clinical studies should be directed to evaluate the impact of each systemic etiological factor and its different types of management on normal amelogenesis. Regarding the diagnosis, future research should focus on the pre-eruption diagnosis and early approaches to prevent the post-eruption breakdown and caries. Regarding the treatment of MIH, future investigations should emphasize further improvements in adhesion and the use of new materials and techniques, such as digital dentistry.

MIH and Dental Caries in Children: A Systematic Review and Meta-Analysis.

(1) Background: Molar-incisor hypomineralization (MIH) is a clinical condition affecting permanent teeth in children, with a documented rising trend in the last two decades. The aim of the present study was to analyze and synthesize the available evidence on caries experience (dmft/DMFT) and MIH in children. (2) Methods: A systematic review and meta-analysis were conducted according to the PRISMA statement. (3) Results: 59 papers published between 2007 and 2022 were included in the qualitative synthesis and 18 in the meta-analysis. The total sample of subjects was 17,717 (mean: 896), of which 2378 (13.4%) had MIH (mean: 119), with a girl/boy ratio of 1:1. The mean age of the enrolled participants was 8.6 (age range 7-10 years). Meta-analysis showed that MIH has a positive correlation with both dmft (effect size of 0.67, 95% CI [0.15, 1.19]) and DMFT (effect size of 0.56, 95% CI [0.41, 0.72]); (4) Conclusions: Children with MIH should be diagnosed correctly and on time. Treatment and management options for moderate and severe forms of MIH should consider prognosis based on known risk factors, and secondary and tertiary prevention policies should also consider the multifactorial nature of caries etiology.

Typical esthetic outcomes using 5 different modalities to treat MIH affected teeth: a case series

Introduction: therapeutic options for incisors affected by Molar Incisor Hypomineralization range from very conservative procedures to those considered to be more invasive. Clinicians must select the appropriate approach, considering the outcomes of the procedures. Methods: this case series presents clinical outcomes of five female patients with aesthetic complaints associated with the Molar Incisor Hipomineralization. Results: macroabrasion, microabrasion and dental vital bleaching were used as combination techniques in three cases. Resin infiltration was indicated for a specific case, considering the oncoming orthodontic treatment. Composite restoration was performed in one patient with posteruptive enamel breakdown. Conclusions: clinicians must select the appropriate approach according to an individualized evaluation of each case, considering factors such as the patient's expectations, dental age, psychosocial period, the severity of the condition, presence of sensitivity and the presumed aesthetic result of the selected treatment. The advantages and disadvantages of the techniques are presented.

Photobiomodulation and glass ionomer sealant as complementary treatment for hypersensitivity in molar incisor hypomineralisation in children: protocol for a blinded randomised clinical trial

IntroductionPhotobiomodulation has been widely used as a complementary treatment for dentin hypersensitivity, with reports of clinical success. However, the literature offers only one study, in which photobiomodulation was used for...